A hand surgeon provides insight on broken thumbs

Dr. Steve Shin, the hand and wrist specialist for the USC football team, the Dodgers, Angels, Lakers, Kings and Ducks, provided me with some insight on thumb injuries.

Shin obviously doesn't know the exact nature of Jay Cutler's broken right thumb, which Bears coach Lovie Smith confirmed Monday morning to WBBM-AM. Smith said the injury occurred in the fourth quarter, when Cutler tried to prevent cornerback Antoine Cason from scoring after an interception.

""Of course we took X-rays last night and he'll be seeing specialists this morning and we'll be able to tell you a little bit more after that," Smith said.

Smith didn't provide a timetable for Cutler's return.

"It all depends on where the fracture is and what kind of fracture," Shin said, a Los Angeles-based surgeon at the Kerlan-Jobe Orthopaedic Clinic.

Shin said an MRI would only be necessary, if there are concerns of a "ligament avulsion, where the ligament between the thumb and index finger actually tears off."

Shin performed surgery on then Cubs first baseman Derrek Lee's torn ligament in his right thumb in November 2010.

Shin then explained the different types of thumb injuries.

He said there are three bones in the thumb.

"You can have a fracture where a piece hasn't moved at all. So in an x-ray of the thumb, you can see the fracture line, but the bone is really good," Shin said.

He called that a "non-displaced fracture."

"Those are pretty benign," he said. "Those don't need surgery. You can treat it with a splint or a cast.
In a quarterbacks' case, even if it's on the throwing hand, if they can wear a splint, to grip the ball and throw, and as long as the pain is tolerable."

A fracture where a piece actually moves often require surgery. He termed that a "displaced fracture."

"You'll obviously be out six to eight weeks," he said. "With surgery, you could move it right away, and you could throw after three weeks. But to get back to that elite, pre-injury level of throwing, it would take six to eight weeks."

A pin, a screw or a plate would help the healing process.

He said the pin is less invasive but that screws and plates are more reliable.